Thoracoscopic diaphragmatic plication.

We report on thoracoscopic plication of the the paralyzed right hemidiaphragm of a 33-year-old woman with a history of reactive airway disease. The paralysis was secondary to transection of the phrenic nerve during right first rib resection for thoracic outlet syndrome 1 year prior to evaluation. By use of video-assisted thoracoscopic surgery (VATS), the diaphragm was plicated as with open thoracotomy. Postoperative recovery was uneventful, with minimal pain and early discharge. Preoperative symptoms of exertional dyspnea and orthopnea were significantly improved.